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2022

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Articles 1561 - 1590 of 23775

Full-Text Articles in Medicine and Health Sciences

Risk-Factor Induced Changes In The Breast Microenvironment Facilitate Inflammatory Breast Cancer Progression And Lymphovascular Invasion, Wintana Balema, Wintana Balema Dec 2022

Risk-Factor Induced Changes In The Breast Microenvironment Facilitate Inflammatory Breast Cancer Progression And Lymphovascular Invasion, Wintana Balema, Wintana Balema

Dissertations and Theses (Open Access)

Inflammatory breast cancer (IBC) is a rapidly progressing, rare and highly lethal form of breast cancer. IBC is a clinical diagnosis, requiring >1/3 involvement on the affected breast and/or skin by erythema, and disease onset of < 6 months. The clinical symptoms of IBC vary in severity and presentation, these include redness, warmth, skin thickening and bruised or pink/purple discoloration appearance and skin changes such as peau d’orange. These skin symptoms are not attributed to inflammation, rather IBC is characterized by florid lymphovascular tumor emboli clogging dermal lymphatics. This leads to “classic” symptoms of breast swelling and skin edema or discoloration. To date, unique genomic drivers which differentiate IBC from non-IBC invasive breast cancers have not been identified highlighting a role for the microenvironment. Several epidemiological studies have unveiled subtype-specific risk factors associated with IBC that are known to alter the microenvironment. Obesity is an established risk factor for all subtypes of IBC. Never-breastfeeding increases risk for developing the most aggressive, triple-negative IBC. Further, never breastfeeding is associated with later clinical stage and worse outcomes. We worked to model these overlapping risk factors to understand microenvironment changes that may lead to the lymphatic change’s indicative of IBC.

First, we investigated the association of a “classic” triad of clinical IBC signs with overall survival among patients to demonstrate the most overt clinical findings of lymphatic involvement were impacting prognosis. We evaluated a triad of IBC signs, including swollen involved breast, nipple change, and diffuse skin change, using breast medical photographs from patients enrolled on a prospective IBC registry. We reported that the …


Concomitant Inhibition Of Flt3 And Mcl-1 In Flt3 Mutated Acute Myeloid Leukemia, Paul Panis Dec 2022

Concomitant Inhibition Of Flt3 And Mcl-1 In Flt3 Mutated Acute Myeloid Leukemia, Paul Panis

Dissertations and Theses (Open Access)

The MCL-1 inhibitor S63845 synergizes with the FLT3 inhibitor midostaurin for potent anti-leukemic effect in preclinical human models of FLT3-ITD mutated acute myeloid leukemia (AML). Acute Myeloid leukemia (AML) is a neoplastic blood disorder defined by a characteristically rapid growth rate and altered behavior of myeloid cells in the bone marrow. The FLT3 receptor is responsible for the upstream regulation of many key processes in hematopoietic cells. FLT3 internal tandem duplication (ITD) mutations are common in leukemia and have been observed in up to a third of newly diagnosed AML patients. FLT3-ITD have been implicated as a driver mutation partly …


Ankyrin Dependent Mitochondrial Function And Bioenergetics In The Heart, Janani Subramaniam, Janani Subramaniam Dec 2022

Ankyrin Dependent Mitochondrial Function And Bioenergetics In The Heart, Janani Subramaniam, Janani Subramaniam

Dissertations and Theses (Open Access)

ANK2 mutations in patients are associated with numerous arrhythmias, cardiomyopathies, and other heart defects. In the heart, AnkB, the protein encoded by ANK2, clusters relevant ion channels and cell adhesion molecules in several important domains; however, its role at Mitochondria Associated ER/SR Membranes (MAMs) has yet to be investigated. MAMs are crucial to mitochondrial function and metabolism and are signaling hubs implicated in various cardiac pathologies. Among several functions, these sites mediate the direct transfer of calcium from the ER/SR to the mitochondria to modulate ATP synthesis. Given that mitochondrial function and energy production are paramount to cardiovascular heath, …


Clinical Outcomes Associated With Co-Infection Of Carbapenem-Resistant Enterobacterales And Other Multidrug-Resistant Organisms, Bekana K Tadese, Stacia M Desantis, Osaro Mgbere, Kayo Fujimoto, Charles Darkoh Dec 2022

Clinical Outcomes Associated With Co-Infection Of Carbapenem-Resistant Enterobacterales And Other Multidrug-Resistant Organisms, Bekana K Tadese, Stacia M Desantis, Osaro Mgbere, Kayo Fujimoto, Charles Darkoh

Faculty, Staff and Student Publications

BACKGROUND: Infections with carbapenem-resistant Enterobacterales (CRE) are associated with increased risk of death. Polymicrobial infections with antimicrobial-resistance may add to the burden of clinical care and patients' clinical prognosis.

AIM: to examine the impact of CRE co-infection with other multi-drug resistant organisms (MDRO) on patient clinical outcomes.

STUDY DESIGN: A retrospective observational study was conducted to compare the clinical outcomes of CRE patients who were co-infected with carbapenem-resistant

RESULTS: A total of 224 CRPA and 209 MDRA co-infections with CRE were identified from 4,236 cases from 2015-2020. The overall 90-day all-cause mortality was 21.6% but increased to 35.0% and 33.5% …


Adverse Drug Events Related To Common Asthma Medications In Us Hospitalized Children, 2000-2016, Luyu Xie, Andrew Gelfand, Matthew S Mathew, Folefac D Atem, Nimisha Srikanth, George L Delclos, Sarah E Messiah Dec 2022

Adverse Drug Events Related To Common Asthma Medications In Us Hospitalized Children, 2000-2016, Luyu Xie, Andrew Gelfand, Matthew S Mathew, Folefac D Atem, Nimisha Srikanth, George L Delclos, Sarah E Messiah

Faculty, Staff and Student Publications

BACKGROUND: The reduction in adverse drug events is a priority in healthcare. Medications are frequently prescribed for asthmatic children, but epidemiological trends of adverse drug events related to anti-asthmatic medications have not been described in hospitalized children.

OBJECTIVE: The objective of this study was to report incidence trends, risk factors, and healthcare utilization of adverse drug events related to anti-asthmatic medications by major drug classes in hospitalized children in the USA from 2000 to 2016.

METHODS: A population-based temporal analysis included those aged 0-20 years who were hospitalized with asthma from the 2000 to 2016 Kids Inpatient Database. Age-stratified weighted …


Design For A Cluster Randomized Controlled Trial To Evaluate The Effects Of The Catch Healthy Smiles School-Based Oral Health Promotion Intervention Among Elementary School Children, Ru-Jye Chuang, Courtney Byrd-Williams, Jose-Miguel Yamal, Kila Johnson, Steven Kelder, Suchitra Nelson, Dania Mofleh, Shreela V Sharma Dec 2022

Design For A Cluster Randomized Controlled Trial To Evaluate The Effects Of The Catch Healthy Smiles School-Based Oral Health Promotion Intervention Among Elementary School Children, Ru-Jye Chuang, Courtney Byrd-Williams, Jose-Miguel Yamal, Kila Johnson, Steven Kelder, Suchitra Nelson, Dania Mofleh, Shreela V Sharma

Faculty, Staff and Student Publications

BACKGROUND: The top two oral diseases (tooth decay and gum disease) are preventable, yet dental caries is the most common childhood disease with 68% of children entering kindergarten having tooth decay. CATCH Healthy Smiles is a coordinated school health program to prevent cavities for students in kindergarten, 1st, and 2nd grade, and is based on the framework of Coordinated Approach to Child Health (CATCH), an evidence-based coordinated school health program. CATCH has undergone several cluster-randomized controlled trials (CRCT) demonstrating sustainable long-term effectiveness in incorporating the factors surrounding children, in improving eating and physical activity behaviors, and reductions in obesity prevalence …


A Qualitative Investigation Of The Barriers And Facilitators To Hepatitis C Virus (Hcv) Screening Among Individuals Experiencing Homelessness In Houston, Texas, Alane Celeste-Villalvir, J Michael Wilkerson, Christine Markham, Lourdes Rodriguez, Vanessa Schick Dec 2022

A Qualitative Investigation Of The Barriers And Facilitators To Hepatitis C Virus (Hcv) Screening Among Individuals Experiencing Homelessness In Houston, Texas, Alane Celeste-Villalvir, J Michael Wilkerson, Christine Markham, Lourdes Rodriguez, Vanessa Schick

Faculty, Staff and Student Publications

BACKGROUND: Individuals experiencing homelessness may be at a higher risk for hepatitis C infection because many are vulnerable to risk factors related to HCV. Screening is the very first step in the HCV care continuum, but it remains unclear how to improve HCV screening among this hard-to-reach population. Thus, the present study investigated the barriers and facilitators to HCV screening from the perspective of individuals experiencing homelessness within a non-residential social service setting.

METHODS: Individuals experiencing homelessness (aged 18+) were approached while they were seeking services at two community-based organizations in Houston, Texas, during August 2020. Participants (

RESULTS: Participants …


Cross-Sectional Area Of The Longus Colli And Cervical Degenerative Spondylolisthesis: A Retrospective Review Evaluating This Anatomic Consideration, Khoa Tran, Aditya Mazmudar, Taylor Paziuk, Mark J. Lambrechts, Eric Tecce, Olivia Blaber, Kamil Okroj, Brian A Karamian, Jose A Canseco, Jeffrey A Rihn, Alan Hilibrand, Christopher Kepler, Alexander R. Vaccaro, Gregory D. Schroeder Dec 2022

Cross-Sectional Area Of The Longus Colli And Cervical Degenerative Spondylolisthesis: A Retrospective Review Evaluating This Anatomic Consideration, Khoa Tran, Aditya Mazmudar, Taylor Paziuk, Mark J. Lambrechts, Eric Tecce, Olivia Blaber, Kamil Okroj, Brian A Karamian, Jose A Canseco, Jeffrey A Rihn, Alan Hilibrand, Christopher Kepler, Alexander R. Vaccaro, Gregory D. Schroeder

Department of Orthopaedic Surgery Faculty Papers

Background: Limited literature is available to define the impact of the longus colli muscle, a deep flexor of the spine, on cervical spine stability despite its close proximity to the vertebrae. Aims and Objectives: The purpose of this study was to determine if longus colli cross-sectional area (CSA) is associated with the severity preoperative cervical degenerative spondylolisthesis. Materials and Methods: Patients undergoing elective anterior cervical discectomy and fusion (ACDF) for cervical spondylolisthesis between 2010-2021 were retrospectively identified. Longus colli cross-sectional areas (CSA) were measured from preoperative MRI images at the C5 level. Preoperative spondylolisthesis measurements were recorded with cervical radiographs. …


Data-Driven Biomarker Panel Discovery In Ovarian Cancer Using Heterogenous Data Fusion On Exosomal And Non-Exosomal Microrna Expression Data, Paritra Mandal Dec 2022

Data-Driven Biomarker Panel Discovery In Ovarian Cancer Using Heterogenous Data Fusion On Exosomal And Non-Exosomal Microrna Expression Data, Paritra Mandal

All Dissertations

Ovarian cancer (OC) is an aggressive gynecological cancer and is currently the 5th leading cause of deaths due to cancer in women. High mortality rates are attributable to the vague pathogenesis and asymptomatic nature of the early stages. The development of a liquid biopsy for routine OC screening could help identify the disease at an earlier stage, making treatments more likely to be effective thereby increasing survival rates. Exosomes, small (~100nm) extracellular vesicles present in body fluids, have been shown to contain cancer-progression, onset, and related factors, making them good candidates for use in liquid biopsies. However, to date, only …


Highly Adherent Antimicrobial Coatings For Orthopedic Implants, Mikhail Bredikhin Dec 2022

Highly Adherent Antimicrobial Coatings For Orthopedic Implants, Mikhail Bredikhin

All Dissertations

Fracture-related infections (FRIs) are the most devasting sort of complications associated with fracture fixation devices, as they lead to patients’ morbidity, prolonged hospitalization, amputations, and even death.External fixators additionally suffer from pin site infections (PSIs), which initiate at the skin entry points of the skin-metallic pin interface present in the external fixation of the damaged bones, often causing deep tissue infection and osteomyelitis. Small percutaneous pins, commonly known as Kirschner wires (K-wires), are used to treat complex fractures and deformities.They are drilled inside the diseased bone for the healing period and are left protruding outside the skin for fixation adjustments …


Scuba Diving Social Identity, Type Of Experience, Sociopsychobio Health, Health-Related Quality Of Life, Self-Efficacy, Disability Level, And Personality Among People With Physical Impairments: A Mixed Methods Study, Tania Santiago Perez Dec 2022

Scuba Diving Social Identity, Type Of Experience, Sociopsychobio Health, Health-Related Quality Of Life, Self-Efficacy, Disability Level, And Personality Among People With Physical Impairments: A Mixed Methods Study, Tania Santiago Perez

All Dissertations

The most common type of disability in the US is mobility or physical impairment, occurring in one in seven adults. Globally, musculoskeletal and neurological conditions account for nearly two-thirds (65.6%) of total physical rehabilitation needs. Approaches that promote healthy community living, rehabilitation, and reduce relapse and rehospitalization among people with physical impairments are critical. Participation in recreational activities and identification with social recreational groups may promote the health, quality of life, and functional abilities of people with physical impairments, contributing to reducing their hospitalization and healthcare needs. This explanatory sequential mixed methods research study had two aims. Using the experience-type …


The Role Of Leisure Engagement In Fostering Cognition In Aging, Karen Wenzel Dec 2022

The Role Of Leisure Engagement In Fostering Cognition In Aging, Karen Wenzel

All Dissertations

Leisure activities are a major component of healthy aging, associated with reduced risk of cognitive decline and enhanced cognitive function. However, there is wide variation in the conceptualization and measurement of leisure. Specific leisure activities or domains have been studied in association with cognition in aging. More recently, researchers have noted that attributes of the activity, rather than the activity itself, may be significant. This study explored the current state of knowledge regarding attributes of leisure activities that foster cognition in aging. A literature review using PRISMA Scoping Review guidelines identified objectively and subjectively measured attributes of leisure engagement in …


18f-Fdg Pet/Ct Staging Of Head And Neck Cancer: Interobserver Agreement And Accuracy—Results From Multicenter Acrin 6685 Clinical Trial, Rathan M Subramaniam, Fenghai M Duan, Justin Romanoff, Jian Qin Yu, Twyla Bartel, Farrokh Dehdashti, Charles M Intenzo, Lilja Solnes, Jorean Sicks, Brendan C Stack, Val J Lowe Dec 2022

18f-Fdg Pet/Ct Staging Of Head And Neck Cancer: Interobserver Agreement And Accuracy—Results From Multicenter Acrin 6685 Clinical Trial, Rathan M Subramaniam, Fenghai M Duan, Justin Romanoff, Jian Qin Yu, Twyla Bartel, Farrokh Dehdashti, Charles M Intenzo, Lilja Solnes, Jorean Sicks, Brendan C Stack, Val J Lowe

Department of Radiology Faculty Papers

To our knowledge, no prior multicenter clinical trial has reported interobserver agreement of 18F-FDG PET/CT scans for staging of clinical N0 neck in head and neck cancer. Methods: A total of 287 participants were recruited. For visual analysis, positive nodal uptake of 18F-FDG was defined as uptake visually greater than activity seen in the blood pool. Results: The negative predictive value of the 18F-FDG PET/CT for N0 clinical neck was 86% or above for visual assessment (95% CI, 86%-88%) for the 2 central readers and above 90% (95% CI, 90%-95%) for SUVmax for central reads and site reads dichotomized at …


Informal Education Experiences Of Black Women-Owned Healthcare Small Businesses In Mississippi, Timothy E. Lampkin Dec 2022

Informal Education Experiences Of Black Women-Owned Healthcare Small Businesses In Mississippi, Timothy E. Lampkin

Graduate Theses and Dissertations

Small businesses are critical to the economic success of the United States, and several states, such as Mississippi, have a strong reliance on small business development. Through small, individually owned businesses, the overall economy is enhanced, and the quality of life for many is improved. A growing trend within the small business community is private ownership by Black women. This population segment has dramatically grown in their presence within business ownership, and it is necessary to describe elements of their success. The proposed research focuses on informal education as an enabler of this small business success. Informal education is a …


Differential Impacts Of Hhv-6a Versus Hhv-6b Infection In Differentiated Human Neural Stem Cells, Elham Bahramian Dec 2022

Differential Impacts Of Hhv-6a Versus Hhv-6b Infection In Differentiated Human Neural Stem Cells, Elham Bahramian

Graduate Theses and Dissertations

Within the family Herpesviridae, sub-family β-herpesvirinae, and genus Roseolovirus, there areonly three human herpesviruses that have been described: HHV-6A, HHV-6B, and HHV-7. Initially, HHV-6A and HHV-6B were considered as two variants of the same virus (i.e., HHV6). Despite high overall genetic sequence identity (~90%), HHV-6A and HHV-6B are now recognized as two distinct viruses. Sequence divergence (e.g., >30%) in key coding regions and significant differences in physiological and biochemical profiles (e.g., use of different receptors for viral entry) underscores the conclusion that HHV-6A and HHV-6B are distinct viruses of the β-herpesvirinae. Despite these viruses being implicated as causative agents in …


Therapists’ Demonstrated Multicultural Competence In Treating Latinx Immigrants, Dulce Diaz Benitez Dec 2022

Therapists’ Demonstrated Multicultural Competence In Treating Latinx Immigrants, Dulce Diaz Benitez

Graduate Theses and Dissertations

Studies suggest that health disparities occur when people from marginalized communities receive care that is inadequate based on their cultural needs (USDHHS, 2011). Multicultural competence (MCC) models have been proposed to provide a framework of the competencies that therapists should develop to work with multicultural populations (Sue et al., 1992). Researchers have questioned the validity of measures, which are mostly based on therapist self-report (Cartwright, 2008). The multicultural case conceptualization ability task has been used in previous studies as a measure of demonstrated cultural competence using a vignette to assess case conceptualization abilities (Ladany et al., 1997). However, it has …


Associations Of The Covid-19 Pandemic With Older Individuals' Healthcare Utilization And Self-Reported Health Status: A Longitudinal Analysis From Singapore, Sangnam Ahn, Seonghoon Kim, Kanghyock Koh Dec 2022

Associations Of The Covid-19 Pandemic With Older Individuals' Healthcare Utilization And Self-Reported Health Status: A Longitudinal Analysis From Singapore, Sangnam Ahn, Seonghoon Kim, Kanghyock Koh

Research Collection School Of Economics

Background: The COVID–19 pandemic has challenged the capacity of healthcare systems around the world and can potentially compromise healthcare utilization and health outcomes among non-COVID–19 patients. Objectives: To examine the associations of the COVID-19 pandemic with healthcare utilization, out-of-pocket medical costs, and perceived health among middle-aged and older individuals in Singapore. Method: Utilizing data collected from a monthly panel survey, a difference-in-differences approach was used to characterize monthly changes of healthcare use and spending and estimate the probability of being diagnosed with a chronic condition and self-reported health status before and during the COVID-19 outbreak in 2020. Subjects: Data were …


Developing A Lifestyle Intervention Program For Overweight Or Obese Preconception, Pregnant And Postpartum Women Using Qualitative Methods, Chee Wai Ku, Shu Hui Leow, Lay See Ong, Christina Erwin, Isabella Ong, Xiang Wen Ng, Jacinth Jia Xin Tan, Fabian Yap, Jerry K. Y. Chan, See Ling Loy Dec 2022

Developing A Lifestyle Intervention Program For Overweight Or Obese Preconception, Pregnant And Postpartum Women Using Qualitative Methods, Chee Wai Ku, Shu Hui Leow, Lay See Ong, Christina Erwin, Isabella Ong, Xiang Wen Ng, Jacinth Jia Xin Tan, Fabian Yap, Jerry K. Y. Chan, See Ling Loy

Research Collection School of Social Sciences

The time period before, during and after pregnancy represents a unique opportunity for interventions to cultivate sustained healthy lifestyle behaviors to improve the metabolic health of mothers and their offspring. However, the success of a lifestyle intervention is dependent on uptake and continued compliance. To identify enablers and barriers towards engagement with a lifestyle intervention, thematic analysis of 15 in-depth interviews with overweight or obese women in the preconception, pregnancy or postpartum periods was undertaken, using the integrated-Promoting Action on Research Implementation in Health Services framework as a guide to systematically chart factors influencing adoption of a novel lifestyle intervention. …


Mind The Gaps: Assessing And Enhancing The Trustworthiness Of Mental Health Apps, Gary Kok Yew Chan Dec 2022

Mind The Gaps: Assessing And Enhancing The Trustworthiness Of Mental Health Apps, Gary Kok Yew Chan

Research Collection Yong Pung How School Of Law

Mental health apps including artificial intelligence (“AI”)- powered apps and chatbots have raised serious concerns relating to safety, efficacy and privacy. This article assesses their trustworthiness based on lego-regulatory, ethical and technological measures in addressing the abovementioned concerns. Focusing on applications to mental health apps, it examines Singapore laws, regulations and guidelines relating to software-based and AI medical devices, data protection, consumer protection, advertising and medical negligence. Additionally, upon taking into account other non-binding ethical guidelines, certification standards and technological measures targeted at app developers, a few recommendations are offered for enhancing trust in mental health apps.


Does Mainstream Brca Testing Affect Surgical Decision-Making In Newly-Diagnosed Breast Cancer Patients?, Quratul Ain, Caroline Richardson, Miriam Mutebi, Angela George, Zoe Kemp, Jennifer E. Rusby Dec 2022

Does Mainstream Brca Testing Affect Surgical Decision-Making In Newly-Diagnosed Breast Cancer Patients?, Quratul Ain, Caroline Richardson, Miriam Mutebi, Angela George, Zoe Kemp, Jennifer E. Rusby

General Surgery, East Africa

Background: Germline pathogenic variants mutations) in the BRCA1 and BRCA2 genes cause an increased risk of breast cancer and ovarian cancer. Mainstream cancer genetic testing (MCG) was introduced for breast cancer patients in our unit in 2013. Non-geneticist clinicians have been trained to offer genetic testing during initial treatment planning. We assessed the impact of timely test results on surgical decision-making.

Methods: Women who had undergone mainstream genetic testing for breast cancer between September 2013 and September 2018 were identified from a prospective database. Surgical data were collected retrospectively.

Results: 580 eligible women had mainstream genetic testing. …


When Intelligence Hurts And Ignorance Is Bliss: Global Pandemic As An Evolutionarily Novel Threat To Happiness, Satoshi Kanazawa, Norman P. Li, Jose C. Yong Dec 2022

When Intelligence Hurts And Ignorance Is Bliss: Global Pandemic As An Evolutionarily Novel Threat To Happiness, Satoshi Kanazawa, Norman P. Li, Jose C. Yong

Research Collection School of Social Sciences

Introduction: The savanna theory of happiness posits that it is not only the current consequences of a given situation that affect happiness but also its ancestral consequences, and that the effect of ancestral consequences on happiness is stronger among less intelligent individuals. But what about situations that did not exist in the ancestral environment and thus have no ancestral consequences? Global pandemic is one such situation that has no ancestral analog, and the theory predicts such evolutionarily novel threats to have a negative effect disproportionately on the life satisfaction of more intelligent individuals.Methods: We analyzed prospectively longitudinal data from population …


Berberis Aristata And Its Secondary Metabolites: Insights Into Nutraceutical And Therapeutical Applications, Firdaus Jahan, Sahir Sultan Alvi, Mohammad Hayatul Islam Dec 2022

Berberis Aristata And Its Secondary Metabolites: Insights Into Nutraceutical And Therapeutical Applications, Firdaus Jahan, Sahir Sultan Alvi, Mohammad Hayatul Islam

School of Medicine Publications

Considering the rising global health challenges and public expectations in terms of safety and cost effectiveness, it is necessary to promote effective, safer and cheaper alternative treatment options, particularly to benefit low- and middle-income countries (LMICs). Therapeutic regimens implying natural sources i.e., plants and their secondary metabolites have been trusted by a large proportion of sufferers and extensively searched for their pharmacological actions. Berberis aristata, commonly known as Zarishk, Daruharidra and Indian barberry, is being used in traditional medicine systems across the globe, particularly Asian countries i.e., India and China, and has also gained much attention …


Moderate-To-Vigorous Physical Activity Is Related With Retinal Neuronal And Axonal Integrity In Persons With Multiple Sclerosis, Jeongwoon Kim, Rachel E. Bollaert, Jonathan Cerna, Brynn C. Adamson, Connor M. Robbs, Naiman A. Khan, Robert W. Motl Dec 2022

Moderate-To-Vigorous Physical Activity Is Related With Retinal Neuronal And Axonal Integrity In Persons With Multiple Sclerosis, Jeongwoon Kim, Rachel E. Bollaert, Jonathan Cerna, Brynn C. Adamson, Connor M. Robbs, Naiman A. Khan, Robert W. Motl

Exercise Science Faculty Research and Publications

Background

Moderate-to-vigorous physical activity (MVPA) may confer benefits for axonal and/or neuronal integrity in adults with multiple sclerosis (MS).

Purpose

Examine the association between device-measured MVPA with optical coherence tomography (OCT) metrics of retinal nerve fiber layer (RNFL) thickness and total macular volume (TMV) in persons with and without MS.

Methods

Adults with MS (N = 41), along with sex-matched healthy control (HC) participants (N = 79), underwent measurements of retinal morphology via OCT and wore an accelerometer for a period of 7 days as a measure of MVPA.

Results

Persons with MS had significantly lower MVPA, RNFL thickness, and …


Benefits Of Early Treatment With Natalizumab: A Real-World Study., Daniel Ontaneda, Ellen M Mowry, Scott D Newsome, Robert T Naismith, Jacqueline Nicholas, Elizabeth Fisher, Carl De Moor, Justin Bohn, Pei-Ran Ho, Al Sandrock, Richard Rudick, James R Williams Dec 2022

Benefits Of Early Treatment With Natalizumab: A Real-World Study., Daniel Ontaneda, Ellen M Mowry, Scott D Newsome, Robert T Naismith, Jacqueline Nicholas, Elizabeth Fisher, Carl De Moor, Justin Bohn, Pei-Ran Ho, Al Sandrock, Richard Rudick, James R Williams

Ambulatory and Primary Care Articles

BACKGROUND: The impact of early versus later high-efficacy disease-modifying therapy (DMT) in patients with multiple sclerosis (MS) is uncertain. This study reported the association of early versus later natalizumab treatment with real-world clinical outcomes in MS patients.

METHODS: The study included 661 participants diagnosed with MS in 1994 or later from 7 US centers participating in the MS Partners Advancing Technology for Health Solutions (MS PATHS) network. Time to natalizumab treatment between diagnosis and first infusion (TTNT) was determined from the Tysabri Outreach: Unified Commitment to Health (TOUCH) registry. Clinical outcomes were defined using neuroperformance tests included in the Multiple …


Species Data And Vector Modeling: Evaluating Datasets For Improved Models Of Ixodes Ricinus Tick Distribution In Europe Under A Changing Climate, Steven Jones Dec 2022

Species Data And Vector Modeling: Evaluating Datasets For Improved Models Of Ixodes Ricinus Tick Distribution In Europe Under A Changing Climate, Steven Jones

Electronic Theses and Dissertations

To increase capacity for monitoring and surveillance of tick-borne diseases, publicly available tick distribution and climate change datasets are required to create accurate predictive distribution models. It is difficult, however, to assess model accuracy and utility when using incomplete datasets.  The more recent development of comprehensive tick databases for Europe and availability of climate change scenarios from multiple IPCC Assessment Reports allows for improved modeling efforts. Multiple tick datasets were combined and three climate change projections were compared by predicting current and future distributions of Ixodes ricinus ticks in Europe using the MaxEnt species distribution model. Overall, much of Europe …


Low-Dose Aspirin For Venous Thromboembolism Prophylaxis Is Associated With Lower Rates Of Periprosthetic Joint Infection After Total Joint Arthroplasty, Farideh Najafi, Joseph K. Kendal, Nicholas V. Peterson, Kerri-Anne Ciesielka, Camilo Restrepo, Javad Parvizi, Nicholas M. Bernthal Dec 2022

Low-Dose Aspirin For Venous Thromboembolism Prophylaxis Is Associated With Lower Rates Of Periprosthetic Joint Infection After Total Joint Arthroplasty, Farideh Najafi, Joseph K. Kendal, Nicholas V. Peterson, Kerri-Anne Ciesielka, Camilo Restrepo, Javad Parvizi, Nicholas M. Bernthal

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Aspirin as a venous thromboembolism (VTE) prophylactic agent has been shown to have antistaphylococcal and antibiofilm roles. Optimal acetylsalicylic acid (ASA) dosage would facilitate antimicrobial effects while avoiding over-aggressive inhibition of platelet antimicrobial function. Our purpose was to determine the periprosthetic joint infection (PJI) rate after total joint arthroplasty in patients receiving low-dose ASA (81 mg twice a day), in comparison to high-dose ASA (325 mg twice a day).

METHODS: We conducted a retrospective cohort study between 2008 and 2020. Eligible patients were older than 18 years, underwent primary total joint arthroplasty, both total knee arthroplasty and total hip …


Cost Utility Of Supporting Family-Based Care To Prevent Hiv And Deaths Among Orphaned And Separated Children In East Africa: A Markov Model–Based Simulation, Marta Wilson-Barthes, Paula Braitstein, Allison Delong, David Ayuku, Lukoye Atwoli, Edwin Sang, Omar Galárraga Dec 2022

Cost Utility Of Supporting Family-Based Care To Prevent Hiv And Deaths Among Orphaned And Separated Children In East Africa: A Markov Model–Based Simulation, Marta Wilson-Barthes, Paula Braitstein, Allison Delong, David Ayuku, Lukoye Atwoli, Edwin Sang, Omar Galárraga

Internal Medicine, East Africa

Purpose: Strengthening family-based care is a key policy response to the more than 15 million orphaned and separated children who have lost 1 or both parents in sub-Saharan Africa. This analysis estimated the cost-effectiveness of family-based care environments for preventing HIV and death in this population.

Design: We developed a time-homogeneous Markov model to simulate the incremental cost per disability-adjusted life year (DALY) averted by supporting family-based environments caring for orphaned and separated children in western Kenya. Model parameters were based on data from the longitudinal OSCAR’s Health and Well-Being Project and published literature. We used a societal perspective, …


Secondhand Smoke Exposure Is Independently Associated With Stroke Among Non-Smoking Adults In West Africa., Akinkunmi Paul Okekunle, Osahon Jeffery Asowata, Adekunle G. Fakunle, Onoja Matthew Akpa, Fred S. Sarfo, Albert Akpalu, Kolawole Wahab, Reginald Obiako, Morenikeji Komolafe, Philip Adebayo Dec 2022

Secondhand Smoke Exposure Is Independently Associated With Stroke Among Non-Smoking Adults In West Africa., Akinkunmi Paul Okekunle, Osahon Jeffery Asowata, Adekunle G. Fakunle, Onoja Matthew Akpa, Fred S. Sarfo, Albert Akpalu, Kolawole Wahab, Reginald Obiako, Morenikeji Komolafe, Philip Adebayo

Internal Medicine, East Africa

Background: Stroke is a leading cause of disability and mortality worldwide, but little is known about the contribution of secondhand smoke exposure (SHSE) to stroke epidemiology among indigenous Africans.

Objective: To evaluate the association of SHSE with stroke among indigenous Africans. Methods We analyzed the relationship of SHSE with stroke among 2990 case-control pairs of adults who had never smoked (identified in the SIREN study) using conditional logistic regression at a two-sided P < 0.05.

Results: Multivariable-adjusted odds ratio and 95% confidence interval; 1.25 (1.04, 1.50; P = 0.02) revealed SHSE was positively associated with stroke independent of stroke subtypes.

Conclusion: …


High Local Control And Low Ocular Toxicity Using Ultra-Low-Dose “Boom-Boom” Radiotherapy For Indolent Orbital Lymphoma, Sanjna Shelukar, Christian Fernandez, Zeynep Bas, Lydia Komarnicky, Sara E. Lally, Carol L Shields, Adam Binder, Pierluigi Porcu, Onder Alpdogan, Ubaldo Martinez-Outschoorn, Wenyin Shi Dec 2022

High Local Control And Low Ocular Toxicity Using Ultra-Low-Dose “Boom-Boom” Radiotherapy For Indolent Orbital Lymphoma, Sanjna Shelukar, Christian Fernandez, Zeynep Bas, Lydia Komarnicky, Sara E. Lally, Carol L Shields, Adam Binder, Pierluigi Porcu, Onder Alpdogan, Ubaldo Martinez-Outschoorn, Wenyin Shi

Department of Medical Oncology Faculty Papers

Background: The first line definitive treatment for early-stage indolent B-cell lymphoma is radiation therapy (RT). Due to the sensitivity of orbital structures to radiation, ultra-low-dose RT (4 Gy in 2 fractions, "boom-boom") has and been utilized as an attractive option for orbital lymphoma. In this retrospective study, we evaluated the outcome and toxicity of "boom-boom" RT for indolent orbital lymphoma with an emphasis on ophthalmologic toxicity.

Methods: This is a retrospective case series with 17 patients with orbital lymphoma who received boom-boom RT at a single tertiary referral center between January 2017 and June 2022. Medical records, imaging and radiation …


Seeing The Big Picture: System Architecture Trends In Endoscopy And Led-Based Hyperspectral Subsystem Intergration, Craig M. Browning Dec 2022

Seeing The Big Picture: System Architecture Trends In Endoscopy And Led-Based Hyperspectral Subsystem Intergration, Craig M. Browning

Graduate Theses and Dissertations (2019 - present)

Early-stage colorectal lesions remain difficult to detect. Early development of neoplasia tends to be small (less than 10 mm) and flat and difficult to distinguish from surrounding mucosa. Additionally, optical diagnosis of neoplasia as benign or malignant is problematic. Low rates of detection of these lesions allow for continued growth in the colorectum and increased risk of cancer formation. Therefore, it is crucial to detect neoplasia and other non-neoplastic lesions to determine risk and guide future treatment. Technology for detection needs to enhance contrast of subtle tissue differences in the colorectum and track multiple biomarkers simultaneously. This work implements one …